Glycemic Dysregulations Are Associated With Worsening Cognitive Function in Older Participants at High Risk of Cardiovascular Disease: Two-Year Follow-up in the PREDIMED-Plus Study
Por:
Gomez-Martinez, C, Babio, N, Julvez, J, Becerra-Tomas, N, Martinez-Gonzalez, M, Corella, D, Castaner, O, Romaguera, D, Vioque, J, Alonso-Gomez, A, Warnberg, J, Martinez, J, Serra-Majem, L, Estruch, R, Tinahones, F, Lapetra, J, Pinto, X, Tur, J, Lopez-Miranda, J, Bueno-Cavanillas, A, Gaforio, J, Matia-Martin, P, Daimiel, L, Martin-Sanchez, V, Vidal, J, Vazquez, C, Ros, E, Dalsgaard, S, Sayon-Orea, C, Sorli, J, de la Torre, R, Abete, I, Tojal-Sierra, L, Baron-Lopez, F, Fernandez-Brufal, N, Konieczna, J, Garcia-Rios, A, Sacanella, E, Bernal-Lopez, M, Santos-Lozano, J, Razquin, C, Alvarez-Sala, A, Goday, A, Zulet, M, Vaquero-Luna, J, Diez-Espino, J, Cuenca-Royo, A, Fernandez-Aranda, F, Bullo, M, Salas-Salvado, J and PREDIMED-Plus Investigators
Publicada:
29 oct 2021
Ahead of Print:
29 oct 2021
Resumen:
Introduction
Type 2 diabetes has been linked to greater cognitive decline, but other glycemic parameters such as prediabetes, diabetes control and treatment, and HOMA-IR and HbA(1c) diabetes-related biomarkers have shown inconsistent results. Furthermore, there is limited research assessing these relationships in short-term studies. Thus, we aimed to examine 2-year associations between baseline diabetes/glycemic status and changes in cognitive function in older participants at high risk of cardiovascular disease. Methods
We conducted a 2-year prospective cohort study (n=6,874) within the framework of the PREDIMED-Plus study. The participants (with overweight/obesity and metabolic syndrome; mean age 64.9 years; 48.5% women) completed a battery of 8 cognitive tests, and a global cognitive function Z-score (GCF) was estimated. At baseline, participants were categorized by diabetes status (no-diabetes, prediabetes, and <5 or >= 5-year diabetes duration), and also by diabetes control. Furthermore, insulin resistance (HOMA-IR) and glycated hemoglobin (HbA(1c)) levels were measured, and antidiabetic medications were recorded. Linear and logistic regression models, adjusted by potential confounders, were fitted to assess associations between glycemic status and changes in cognitive function. Results
Prediabetes status was unrelated to cognitive decline. However, compared to participants without diabetes, those with >= 5-year diabetes duration had greater reductions in GCF (beta=-0.11 (95%CI -0.16;-0.06)], as well as in processing speed and executive function measurements. Inverse associations were observed between baseline HOMA-IR and changes in GCF [beta=-0.0094 (95%CI -0.0164;-0.0023)], but also between HbA(1c) levels and changes in GCF [beta=-0.0085 (95%CI -0.0115, -0.0055)], the Mini-Mental State Examination, and other executive function tests. Poor diabetes control was inversely associated with phonologic fluency. The use of insulin treatment was inversely related to cognitive function as measured by the GCF [beta=-0.31 (95%CI -0.44, -0.18)], and other cognitive tests. Conclusions
Insulin resistance, diabetes status, longer diabetes duration, poor glycemic control, and insulin treatment were associated with worsening cognitive function changes in the short term in a population at high cardiovascular risk.
Filiaciones:
Gomez-Martinez, C:
Univ Rovira & Virgili, Dept Bioquim & Biotecnol, Unitat Nutr Humana, Reus, Spain
Hosp Univ San Joan Reus, Inst Invest Sanitaria Pere Virgili IISPV, Reus, Spain
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Babio, N:
Univ Rovira & Virgili, Dept Bioquim & Biotecnol, Unitat Nutr Humana, Reus, Spain
Hosp Univ San Joan Reus, Inst Invest Sanitaria Pere Virgili IISPV, Reus, Spain
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Hosp St Joan Reus, Nutr Unit, Reus, Spain
Julvez, J:
Hosp Univ San Joan Reus, Inst Invest Sanitaria Pere Virgili IISPV, Reus, Spain
Becerra-Tomas, N:
Univ Rovira & Virgili, Dept Bioquim & Biotecnol, Unitat Nutr Humana, Reus, Spain
Hosp Univ San Joan Reus, Inst Invest Sanitaria Pere Virgili IISPV, Reus, Spain
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Martinez-Gonzalez, M:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Navarra, Inst Invest Sanitaria Navarra IdISNA, Dept Prevent Med & Publ Hlth, Pamplona, Spain
Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA
Corella, D:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Valencia, Dept Prevent Med, Valencia, Spain
Castaner, O:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Hosp Del Mar Res Inst IMIM, Cardiovasc Risk & Nutr Res Grp CARIN, Barcelona, Spain
Romaguera, D:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Hosp Son Espases, Hlth Res Inst Balearic Isl IdISBa, Palma De Mallorca, Spain
:
ISCIII, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Miguel Hernandez Univ, Nutr Epidemiol Unit, Alicante, Spain
Univ Miguel Hernandez ISABIAL UMH, Inst Invest Sanitaria & Biomed Alicante, Alicante, Spain
Alonso-Gomez, A:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Basque Country, Araba Univ Hosp, Bioaraba Hlth Res Inst,Euskal Herriko Unibertsita, Osakidetza Basque Hlth Serv,Univ Basque Country, Vitoria, Spain
Warnberg, J:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Malaga, Sch Hlth Sci, Inst Invest Biomed Malaga IBIMA, EpiPHAAN Res Grp, Malaga, Spain
Martinez, J:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Navarra, Inst Invest Sanitaria Navarra IdISNA, Dept Nutr Food Sci & Physiol, Pamplona, Spain
Campus Excelencia Int Univ Autonoma Madrid Consej, Precis Nutr & Cardiometab Hlth Program, Cardiometab Nutr Grp, IMDEA Food, Madrid, Spain
Serra-Majem, L:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Las Palmas Gran Canaria, Ctr Hosp Univ Insular Materno Infantil CHUIMI, Res Inst Biomed & Hlth Sci IUIBS, Prevent Med Serv, Las Palmas Gran Canaria, Spain
Estruch, R:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Barcelona, Hosp Clin, Inst Invest Biomed August Pi Sunyer IDIBAPS, Dept Internal Med, Barcelona, Spain
Tinahones, F:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Malaga, Virgen de la Victoria Hosp, Inst Invest Biomed Malaga IBIMA, Dept Endocrinol, Malaga, Spain
Lapetra, J:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Dist Sanitario Atenc Primaria Sevilla, Res Unit, Dept Family Med, Seville, Spain
Pinto, X:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Hosp Univ Bellvitge IBIDELL, Lipids & Vasc Risk Unit, Internal Med, Barcelona, Spain
Univ Barcelona, Barcelona, Spain
Tur, J:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Balearic Isl, Res Grp Community Nutr & Oxidat Stress, Inst Univ Invest Ciencias Salud IUNICS, Palma De Mallorca, Spain
Hlth Res Inst Balearic Isl IdkSBa, Palma De Mallorca, Spain
Lopez-Miranda, J:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Biomed Res Inst Cordoba IMIBIC, Dept Internal Med, Cordoba, Spain
Bueno-Cavanillas, A:
ISCIII, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Granada, Dept Prevent Med, Granada, Spain
Inst Invest Biosanit Ibs GRANADA, Granada, Spain
Gaforio, J:
ISCIII, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Univ Jaen, Inst Univ Invest Olivar & Aceites Oliva, Dept Ciencias Salud, Jaen, Spain
Matia-Martin, P:
Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Dept Endocrinol & Nutr, Madrid, Spain
Daimiel, L:
CEI UAM CSIC, IMDEA Food, Precis Nutr & Obes Program, Nutr Control Epigenome Grp, Madrid, Spain
Martin-Sanchez, V:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Leon, Inst Biomed IBIOMED, Leon, Spain
Vidal, J:
ISCIII, CIBER Diabet & Enfermedades Metab CIBERDEM, Madrid, Spain
Univ Barcelona, Hosp Clin, Inst Invest Biomed August Pi & Sunyer IDIBAPS, Dept Endocrinol, Barcelona, Spain
Vazquez, C:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Fdn Jimenez Diaz, Dept Endocrinol, Madrid, Spain
Ros, E:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Hosp Clin Barcelona, Dept Endocrinol & Nutr, IDIBAPS, Lipid Clin, Barcelona, Spain
Dalsgaard, S:
Lundbeck Fdn Initiat Integrat Psychiat Res, iPSYCH, Aarhus, Denmark
Aarhus Univ, Natl Ctr Register Based Res, Aarhus, Denmark
Sayon-Orea, C:
Univ Navarra, Inst Invest Sanitaria Navarra IdISNA, Dept Prevent Med & Publ Hlth, Pamplona, Spain
Sorli, J:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Valencia, Dept Prevent Med, Valencia, Spain
de la Torre, R:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Hosp del Mar Med Res Inst IMIM, Integrated Pharmacol & Syst Neurosci Res Grp, Barcelona, Spain
Univ Pompeu Fabra, Dept Ciencias Expt & Salud CEXS, Barcelona, Spain
Abete, I:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Navarra, Inst Invest Sanitaria Navarra IdISNA, Dept Nutr Food Sci & Physiol, Pamplona, Spain
Tojal-Sierra, L:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Basque Country, Araba Univ Hosp, Bioaraba Hlth Res Inst,Euskal Herriko Unibertsita, Osakidetza Basque Hlth Serv,Univ Basque Country, Vitoria, Spain
Baron-Lopez, F:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Malaga, Sch Hlth Sci, Inst Invest Biomed Malaga IBIMA, EpiPHAAN Res Grp, Malaga, Spain
Fernandez-Brufal, N:
Ctr Salud San Fermin, Elche, Spain
Konieczna, J:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Hosp Son Espases, Hlth Res Inst Balearic Isl IdISBa, Palma De Mallorca, Spain
Garcia-Rios, A:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Biomed Res Inst Cordoba IMIBIC, Dept Internal Med, Cordoba, Spain
Sacanella, E:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Barcelona, Hosp Clin, Inst Invest Biomed August Pi Sunyer IDIBAPS, Dept Internal Med, Barcelona, Spain
Bernal-Lopez, M:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Malaga, Reg Univ Hosp Malaga, Inst Invest Biomed Malaga IBIMA, Dept Internal Med, Malaga, Spain
Santos-Lozano, J:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Dist Sanitario Atenc Primaria Sevilla, Res Unit, Dept Family Med, Seville, Spain
Razquin, C:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Navarra, Inst Invest Sanitaria Navarra IdISNA, Dept Prevent Med & Publ Hlth, Pamplona, Spain
Alvarez-Sala, A:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Valencia, Dept Prevent Med, Valencia, Spain
Goday, A:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Hosp Del Mar Res Inst IMIM, Cardiovasc Risk & Nutr Res Grp CARIN, Barcelona, Spain
Zulet, M:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Navarra, Inst Invest Sanitaria Navarra IdISNA, Dept Nutr Food Sci & Physiol, Pamplona, Spain
Vaquero-Luna, J:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Basque Country, Araba Univ Hosp, Bioaraba Hlth Res Inst,Euskal Herriko Unibertsita, Osakidetza Basque Hlth Serv,Univ Basque Country, Vitoria, Spain
Diez-Espino, J:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Navarra, Inst Invest Sanitaria Navarra IdISNA, Dept Prevent Med & Publ Hlth, Pamplona, Spain
Gerencia Atenc Primaria Serv Navarro Salud Osasun, Navarra, Spain
Cuenca-Royo, A:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Hosp Del Mar Res Inst IMIM, Cardiovasc Risk & Nutr Res Grp CARIN, Barcelona, Spain
Fernandez-Aranda, F:
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Hosp Bellvitge, Dept Psychiat, Inst Invest Biomed Bellvitge IDIBELL, Barcelona, Spain
Univ Barcelona, Sch Med & Hlth Sci, Dept Clin Sci, Barcelona, Spain
Bullo, M:
Univ Rovira & Virgili, Dept Bioquim & Biotecnol, Unitat Nutr Humana, Reus, Spain
Hosp Univ San Joan Reus, Inst Invest Sanitaria Pere Virgili IISPV, Reus, Spain
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Salas-Salvado, J:
Univ Rovira & Virgili, Dept Bioquim & Biotecnol, Unitat Nutr Humana, Reus, Spain
Hosp Univ San Joan Reus, Inst Invest Sanitaria Pere Virgili IISPV, Reus, Spain
Inst Salud Carlos III ISCIII, MP Fisiopatol Obesidad & Nutr CIBERObn, Consorcio CIBER, Madrid, Spain
Univ Hosp St Joan Reus, Nutr Unit, Reus, Spain
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